CancerPhase 2NCT00236041
Efficacy/Safety Study of ACTIQ® for Opioid-Tolerant Children and Adolescents With Breakthrough Pain (BTP)
A Phase 2 study testing ACTIQ® in people with Cancer and Breakthrough Pain, run by Cephalon at 31 sites in 2 countries.
Trial summary
The primary objective of the study is to evaluate the efficacy of ACTIQ treatment for the management of breakthrough pain (BTP) compared to placebo treatment in children with cancer and non-cancer pain who are receiving around-the-clock (ATC) opioid therapy and who require additional therapy for BTP episodes. Read more about this study
- Who is it for?
- Ages 3 to 15 years
- Conditions the study is for
- Cancer, Breakthrough Pain
- What is being tested?
- ACTIQ®
- How many people
- 38 participants
- Where
- 31 sitesin 2 countries
- Study dates
- Apr 2004to Aug 2006
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 3 to 15 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Written informed consent of the parent or legal guardian and patient assent, when appropriate, is obtained. (Lack of assent cannot be overturned.)
- The child is aged 3 to under 16 years and weighs at least 15 kg.
- The child must be using ATC opioid therapy for pain associated with cancer and be opioid-tolerant. NOTE: This requirement is defined as the patient receiving at least 1 mg/kg/day or 40 mg/day or more of oral morphine (or an equi-analgesic dosage of another opioid) or at least 25 mcg/hour of transdermal fentanyl for at least 7 days, (ATC opioid therapy may be administered as patient-controlled analgesia [PCA]).
- The child must be experiencing episodes of BTP (defined as a transient flare of pain that requires a bolus of medication as treatment) as follows:
- patients with cancer must be experiencing an average of at least 1 BTP episode a day.
- patients with non-cancer related pain must be experiencing an average of 2 BTP episodes a day.
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- The child has an average daily pain score of 6 or less (of 10) on the FPS-R.
- Girls who are postmenarche or sexually active must have a negative urine pregnancy test prior to the baseline visit, must be using a medically acceptable method of birth control, and must agree to continue use of this method for the duration of the study (and for 30 days after participation in the study). Acceptable methods of birth control include: barrier method with spermicide; steroidal contraceptive (eg, oral, transdermal, implanted, or injected) in conjunction with a barrier method; intrauterine device (IUD); or abstinence.
- The child, in the opinion of the investigator, is able to administer ACTIQ treatment effectively (ie, adequately moving the unit around in the mouth and sucking, not biting, the unit).
- The child must be an inpatient.
Who cannot join
- The child has pain uncontrolled by therapy, as determined by the investigator, that could adversely impact the safety of the patient or could be compromised by treatment with ACTIQ.
- The child has known or suspected hypersensitivities/allergies or other contraindications to any ACTIQ component.
- The child has received monoamine oxidase inhibitors (MAOIs) within 14 days before the first ACTIQ treatment.
- The child has moderate to severe oral mucositis.
- The child has a neuromuscular disease, significant renal impairment, or significant hepatic impairment as determined by the investigator.
- The child has any other medical condition or is receiving concomitant medication/therapy that would, in the opinion of the investigator, compromise the patient's safety or compliance with the study protocol, or compromise data collection.
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- The child has received any experimental drug/therapy within 14 days of the first ACTIQ treatment. NOTE: Children may not be participating concurrently in another study when the other study requires experimental drug therapy.
- A child's exacerbations of pain are only associated with medical procedures (such as radiation therapy, wound dressing, and bone marrow aspiration).
- The child is receiving any other treatment that, in the opinion of the investigator, could interfere with the pain response.
- For a female patient of childbearing potential: is pregnant or lactating. (Any female patient becoming pregnant during the study will be withdrawn from the study.)
- The child has, in the opinion of the investigator, developmental delay that would interfere with the use of ACTIQ therapy.
Trial locations and contacts
31 sites in 2 countries.
31 sites in 2 countries
United States30 sites
Akron Children's Hospital
Akron, Ohio, 44308
University of New Mexico
Albuquerque, New Mexico, 87131
Scottish Rite Children's Medical Center
Atlanta, Georgia, 30342
Children's Memorial Center
Chicago, Illinois, 60614
Children's Memorial Hospital
Chicago, Illinois, 60614
Duke University Hospital
Durham, North Carolina, 27710
Hackensack University Medical Center
Hackensack, New Jersey, 07601
Connecticut Childrens Medical Center
Hartford, Connecticut, 06106
Milton S Hershey Medical Center
Hershey, Pennsylvania, 17033
Kapi'olani Medical Center
Honolulu, Hawaii, 96826
University Hospitals of Iowa
Iowa City, Iowa, 52242
Nemours Childrens Clinic
Jacksonville, Florida, 32207
Children's Hospital of Arkansas
Little Rock, Arkansas, 72202
UCLA Pediatric Pain Program
Los Angeles, California, 90095
Childrens Hospital of Wisconsin
Milwaukee, Wisconsin, 53201
West Virginia University
Morgantown, West Virginia, 99204
Vanderbilt University Medical
Nashville, Tennessee, 37232
Cancer Institute of New Jersey
New Brunswick, New Jersey, 08901
Childrens Hospital of Orange
Orange, California, 92868
Lucille Packard Childrens Hospital
Palo Alto, California, 94304
St. Christopher's Hospital for Children
Philadelphia, Pennsylvania, 19134
Children's Cancer and Blood Disorders Center
San Antonio, Texas, 78207
Methodist Hospital
San Antonio, Texas, 78229
Sacred Heart Medical Center
Spokane, Washington, 99204
Cardinal Glennon Children's Hospital
St Louis, Missouri, 63104
SUNY Upstate Medical University
Syracuse, New York, 13210
St. Joseph's Children's Hospital
Tampa, Florida, 33607
Children's Hospital at Montefiore
The Bronx, New York, 10467
Children's National Medical Center
Washington D.C., District of Columbia, 20010
Tod Children's Hospital
Youngstown, Ohio, 44501
About this study
Official title: A Double-Blind, Placebo-Comparison Study to Evaluate the Efficacy and Safety of ACTIQ® (Oral Transmucosal Fentanyl Citrate [OTFC®]) Treatment for Opioid-Tolerant Children and Adolescents With Breakthrough Pain
The primary objective of the study is to evaluate the efficacy of ACTIQ treatment for the management of breakthrough pain (BTP) compared to placebo treatment in children with cancer and non-cancer pain who are receiving around-the-clock (ATC) opioid therapy and who require additional therapy for BTP episodes. This will be determined by the analysis of the pain intensity (PI), measured by the Faces Pain Scale-Revised (FPS-R) administered 15 minutes after the start of each unit of study drug with an optimal ACTIQ dosage.
Read the detailed description
The primary objective of the study is to evaluate the efficacy of ACTIQ treatment for the management of breakthrough pain (BTP) compared to placebo treatment in children with pain who are receiving around-the-clock (ATC) opioid therapy and who require additional therapy for BTP episodes. This will be determined by the analysis of the pain intensity (PI), measured by the Faces Pain Scale-Revised (FPS-R) administered 15 minutes after the start of each unit of study drug with an optimal ACTIQ dosage.
The secondary objectives are:
- to evaluate the characteristics of BTP in children with pain, including their response to treatment
- to evaluate the efficacy of ACTIQ treatment compared to placebo treatment for these children with regard to time to adequate analgesia by utilizing a stop watch to measure the time for each unit of study drug in the double blind phase
- to evaluate the efficacy of ACTIQ treatment compared to placebo treatment for these children by assessing the occurrence of inadequate analgesia as assessed by the use of rescue medication
- to evaluate the efficacy of ACTIQ treatment compared to placebo treatment for these children by assessing the numbers of patients who withdraw from the study because of inadequate analgesia
- to evaluate the efficacy of ACTIQ treatment compared to placebo treatment for these children by assessing the duration of analgesic effect by using the FPS-R administered at approximately 30, 45, and 60 minutes after the start of each unit of study drug after an optimal dosage is obtained
- to determine the distribution of optimal doses of ACTIQ treatment for these children by age group (3 to under 6 years, 6 to under 11 years, and 11 to under 16 years)
- to establish a safe and effective titration scheme for ACTIQ in these children during the open label phase
- to evaluate the safety of ACTIQ treatment for these children through the assessment of adverse events, clinical laboratory assessments (serum chemistry and hematology), vital sign measurements (including blood pressure, heart rate, and respiration rate), hemoglobin-oxygen saturation level (SpO2, measured via pulse oximetry), electrocardiograms (ECGs), physical examinations, and level of sedation (measured by the University of Michigan Sedation Scale [UMSS])
- to characterize the pharmacokinetics profile of ACTIQ (fentanyl citrate) in these children
- to investigate the exposure and efficacy relationship between plasma concentration of fentanyl and clinical measures of analgesia
- Conditions
- Cancer, Breakthrough Pain
- Being tested
- ACTIQ®
- Keywords
- Breakthrough Pain, Cancer, Sickle Cell, Severe Burns, Children, Adolescents, Analgesia, Sickle Cell Disease, Non-Cancer
- Medical subject headings
- Neoplasms, Breakthrough Pain, Burns, Agnosia, Anemia, Sickle Cell
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ACTIQ®Drug
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain intensity differences as measured by the FPS-R
Secondary outcomes (5)
Time to adequate analgesia
Duration of analgesia
Percentage of BTP episodes requiring rescue medication, or for which oversedation occurs
Amount of rescue medication
Distribution of optimal doses
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Oct 2005 (estimated)
- Study startApr 2004
- Study completionAug 2006
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Double blind
- Enrolment
- 38 participants
Sponsor and investigators
- Lead sponsor
- Cephalon
- Sponsor type
- Industry (pharma, biotech, devices)
- Investigators
- John Messina, Pharm D, Study director, Cephalon, Inc.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00236041
- Sponsor's protocol ID
- C8278b/202/BP/US-CA
- Status last verified
- May 2014
- First submitted
- 7 Oct 2005
- Last updated
- 9 May 2014
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 May 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Double-Blind, Placebo-Comparison Study to Evaluate the Efficacy and Safety of ACTIQ® (Oral Transmucosal Fentanyl Citrate [OTFC®]) Treatment for Opioid-Tolerant Children and Adolescents With Breakthrough Pain
- ClinicalTrials.gov ID
- NCT00236041
- Acronym / sponsor ID
- C8278b/202/BP/US-CA
- Conditions
- Cancer, Breakthrough Pain
- Keywords
- Breakthrough Pain, Cancer, Sickle Cell, Severe Burns, Children, Adolescents, Analgesia, Sickle Cell Disease
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 38 participants
- Lead sponsor
- CephalonIndustry (pharma, biotech, devices)
- Study start
- Apr 2004
- Study completion
- Aug 2006
- First posted
- 12 Oct 2005 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary objective of the study is to evaluate the efficacy of ACTIQ treatment for the management of breakthrough pain (BTP) compared to placebo treatment in children with cancer and non-cancer pain who are receiving around-the-clock (ATC) opioid therapy and who require additional therapy for BTP episodes. This will be determined by the analysis of the pain intensity (PI), measured by the Faces Pain Scale-Revised (FPS-R) administered 15 minutes after the start of each unit of study drug with an optimal ACTIQ dosage.
Detailed description
The primary objective of the study is to evaluate the efficacy of ACTIQ treatment for the management of breakthrough pain (BTP) compared to placebo treatment in children with pain who are receiving around-the-clock (ATC) opioid therapy and who require additional therapy for BTP episodes. This will be determined by the analysis of the pain intensity (PI), measured by the Faces Pain Scale-Revised (FPS-R) administered 15 minutes after the start of each unit of study drug with an optimal ACTIQ dosage.
The secondary objectives are:
- to evaluate the characteristics of BTP in children with pain, including their response to treatment
- to evaluate the efficacy of ACTIQ treatment compared to placebo treatment for these children with regard to time to adequate analgesia by utilizing a stop watch to measure the time for each unit of study drug in the double blind phase
- to evaluate the efficacy of ACTIQ treatment compared to placebo treatment for these children by assessing the occurrence of inadequate analgesia as assessed by the use of rescue medication
- to evaluate the efficacy of ACTIQ treatment compared to placebo treatment for these children by assessing the numbers of patients who withdraw from the study because of inadequate analgesia
- to evaluate the efficacy of ACTIQ treatment compared to placebo treatment for these children by assessing the duration of analgesic effect by using the FPS-R administered at approximately 30, 45, and 60 minutes after the start of each unit of study drug after an optimal dosage is obtained
- to determine the distribution of optimal doses of ACTIQ treatment for these children by age group (3 to under 6 years, 6 to under 11 years, and 11 to under 16 years)
- to establish a safe and effective titration scheme for ACTIQ in these children during the open label phase
- to evaluate the safety of ACTIQ treatment for these children through the assessment of adverse events, clinical laboratory assessments (serum chemistry and hematology), vital sign measurements (including blood pressure, heart rate, and respiration rate), hemoglobin-oxygen saturation level (SpO2, measured via pulse oximetry), electrocardiograms (ECGs), physical examinations, and level of sedation (measured by the University of Michigan Sedation Scale [UMSS])
- to characterize the pharmacokinetics profile of ACTIQ (fentanyl citrate) in these children
- to investigate the exposure and efficacy relationship between plasma concentration of fentanyl and clinical measures of analgesia
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Double blind
Who may qualify
- Ages
- 3 to 15 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (10 listed)
- Written informed consent of the parent or legal guardian and patient assent, when appropriate, is obtained. (Lack of assent cannot be overturned.)
- The child is aged 3 to under 16 years and weighs at least 15 kg.
- The child must be using ATC opioid therapy for pain associated with cancer and be opioid-tolerant. NOTE: This requirement is defined as the patient receiving at least 1 mg/kg/day or 40 mg/day or more of oral morphine (or an equi-analgesic dosage of another opioid) or at least 25 mcg/hour of transdermal fentanyl for at least 7 days, (ATC opioid therapy may be administered as patient-controlled analgesia [PCA]).
- The child must be experiencing episodes of BTP (defined as a transient flare of pain that requires a bolus of medication as treatment) as follows:
- The child has an average daily pain score of 6 or less (of 10) on the FPS-R.
Key exclusion criteria (11 listed)
- The child has pain uncontrolled by therapy, as determined by the investigator, that could adversely impact the safety of the patient or could be compromised by treatment with ACTIQ.
- The child has known or suspected hypersensitivities/allergies or other contraindications to any ACTIQ component.
- The child has received monoamine oxidase inhibitors (MAOIs) within 14 days before the first ACTIQ treatment.
- The child has moderate to severe oral mucositis.
- The child has a neuromuscular disease, significant renal impairment, or significant hepatic impairment as determined by the investigator.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ACTIQ® | Drug | – |
Primary outcome
Pain intensity differences as measured by the FPS-R
5 secondary outcomes
Time to adequate analgesia
Duration of analgesia
Percentage of BTP episodes requiring rescue medication, or for which oversedation occurs
Amount of rescue medication
Distribution of optimal doses
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 May 2014.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
John Messina, Pharm D study director
Cephalon, Inc.
31 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing ACTIQ® in people with Cancer and Breakthrough Pain, run by Cephalon at 31 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 9 May 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 31 sites in United States, Puerto Rico. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain intensity differences as measured by the FPS-R. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 May 2014.